Malaysia works to break the cycle of mother-to-child HIV transmission

Malaysian children finish their schoolwork at a special home for children affected by HIV and AIDS.

By Steve Nettleton

KUALA LUMPUR / LANGKAWI, April 2007 – Puteri, 12, picks up a large orange tablet and drops it into her mouth. It takes two gulps of water before she manages to swallow it. She frowns, looking at the small dish in her hand containing three other pills of various shapes and colours.

Taking this medicine is not the favourite part of her daily routine, but Puteri (not her real name) knows they are there to make her feel better. She longs for the day she can put the pills behind her and transform her thin frame into one more like a healthy pre-teen.

“I dream of getting cured,” she says.

Women and children at risk

Puteri was born with HIV. Both of her parents died of AIDS-related illnesses when she was very young. She lived with her grandmother in the northern state of Kedah until December 2006, when her declining health required care too specialised and time-consuming for her grandmother, who also had to support Puteri’s two teenage sisters.

She then came to live at a special home in Kuala Lumpur for children affected by HIV and AIDS. It has been a difficult adjustment.

Like Puteri, most of the 14 boys and girls at this home have lost one or both parents to HIV/AIDS. Some have been abandoned. All have suffered one way or another from the disease.

By official estimates, at least 1,000 children in Malaysia have been infected with HIV, and AIDS groups believe there are at least hundreds more who are HIV-positive but have not been tested. Women account for a growing proportion of new HIV cases. Consequently, more children are being born with HIV.

Siti, an HIV-positive mother with her HIV-negative five-year old son and her nine-month old daughter, who has also so far tested HIV-negative as a result of the Government's free PMTCT program.

It’s an upward spiral that need not continue.

Malaysia has stepped up efforts to prevent HIV infection from mother to child. Under a program introduced by the Ministry of Health, pregnant women who visit government clinics are tested for HIV and those found positive are offered post-test counselling and anti-retroviral (ARV) treatment throughout their pregnancy.

Mothers who participate in the program receive free ARVs for life. Their newborn babies are also put on treatment and given regular tests for HIV.

‘Medicine to save my baby’

Siti (not her real name), a mother of five on the island of Langkawi, is hopeful the Government program has spared her children from HIV. Infected by her husband, who died in January, Siti only learned she had the virus once she was pregnant with her fourth child, now five years old.

“When I realised I was HIV positive and pregnant, I lost all sense of hope. I was afraid I was going to pass this virus to my baby,” says Siti. “But the medical team explained that they were going to give me medicine to save my baby. It was only after this that I started feeling happier with life, when I was told there was hope to prevent my unborn baby from getting HIV.”

With treatment, Siti’s baby was born free of the virus. Four years later, she again became pregnant with her youngest daughter. Now nine months old, the girl has also tested negative for HIV, but it won’t be until she is two years old that doctors can be certain she is not infected.

By providing more women like Siti access to treatment, UNICEF and the Malaysian Government hope that fewer children will have to grow up in special refuges, sparing them a childhood burdened by sickness and stigma.